This
page lists citation information and abstracts for articles on civic
engagement and later life that were published in The Gerontologist,
The Journals of Gerontology: Psychological Sciences, and
The Journals of Gerontology: Social Sciences between January
1999 and July 2006. The information is organized under the following
subheadings:

Data were
collected from 252 coresident caregiving daughters and daughters-in-law
and their husbands. We hypothesized that biological children would
give more care than children-in-law and that children-in- law
would have very different caregiving experiences and resultant
appraisals than biological children. Contrary to our hypotheses,
we found that the experiences are very similar for biological
children and children-in-law in caregiving families. We suggested
that the important factor is not the relationship to the elder
that has the impact--it is the quality of the relationship with
the elder that is consistently significant.

Family caregivers
of patients facing high numbers of new demands for assistance
following hospital discharge were more likely to experience increased
levels of depression in the following six months compared with
caregivers facing similar overall demands but few new demands
for assistance following hospital discharge. New demands for assistance
had a significant independent effect upon the levels of depression
and were independent of family relationship (spouse vs nonspouse)
and caregiver gender. These findings provide insight into theories
of caregiver stress, begin to specify the interaction of time
following the onset of a stressful event and caregivers' subsequent
reactions, and suggest which caregivers may require some assistance
following discharge of their patients.

This article
explores the relationships between caregiving stressors and caregiver
well-being in a representative community sample of disabled elders
and their informal caregivers. The direct and indirect effects
of stressors and potential mediators on the outcome of caregiver
psychological well-being, as measured by depression, were examined
using path analysis. Potential mediators of the primary stressors
on depression included mastery, emotional support; quality of
relationship between the caregiver and the care recipient, formal
service use and role overload. Findings indicate that the caregiving
stressors (needs for care) led to caregiver depression indirectly
through their effect on hours of care provided and the resulting
caregiver perception of role overload. Quality of the caregiver/care
recipient relationship mediated the relationship of the caregiving
stressors and caregiver overload and depression. Finally, regardless
of the level of primary stressors, caregivers with high levels
of mastery or emotional support were at lower risk of depression.
These findings can be used to inform the design of proactive caregiver
interventions.

The
effects of family conflict resolution and decision making on the
provision of help for an elder with Alzheimer's disease
MA Lieberman and L Fisher (1999) The Gerontologist, Vol
39, Issue 2 159-166

This study
explored how characteristics of multigeneration families of patients
with Alzheimer's disease (AD) affected the family's ability to
provide help to their ill elder. An intensive patient and family
assessment battery was employed with 211 families with an elder
with AD, and measures of the amount and kind of help offered by
the family group were recorded. Above and beyond control variables,
families that used a focused decision-making style and positive
conflict resolution methods provided more help than families that
did not use these styles and methods. These data suggest the importance
of the family system of care in disease management.

Analyzing
data from more than 1,500 family caregivers from the 1996 National
Caregiver Survey, this study documents the ways in which dementia
care is different from other types of family caregiving. Not only
do dementia caregivers spend significantly more hours per week
providing care than nondementia caregivers, they also report greater
impacts in terms of employment complications, caregiver strain,
mental and physical health problems, time for leisure and other
family members, and family conflict. Differential impacts remain
even after controlling for intensity of caregiving involvement
and sociodemographic factors. Study findings suggest the need
to tailor programs and services to the unique challenges faced
by dementia caregivers.

This 3-year
randomized clinical trial tested the effectiveness of an interdisciplinary
psychoeducational family group intervention in decreasing the
caregivers' perceptions of the frequency and severity of behavioral
problems in persons with dementia and their reactions to those
problems, and in decreasing caregiver burden and depression. The
intervention consisted of seven weekly, 2-hour multimedia training
sessions that included education, family support, and skills training
for 94 primary caregivers and their families. Repeated measures
ANOVA was used to test for significant differences between the
intervention and waiting list control groups over a 5-month period.
The intervention was successful in reducing caregivers' negative
reactions to disruptive behaviors and in reducing caregiver burden
over time.

This study
tested the cross-sectional relationship between caregiver burden
and health-related quality of life (HRQOL) among 1,594 caregivers
of veterans identified to qualify for formal home care. A two-stage
model found that familial relationship, coresidence, and low income
predicted objective burden. Coresidence also predicted subjective
burden, whereas being African American was protective. In the
full model, spousal relationship, low income, and burden were
associated with poor HRQOL scores. Total variance explained in
HRQOL ranged from 14% to 29%, with objective burden contributing
more than subjective burden. These findings suggest a direct effect
of objective burden on caregiver HRQOL, indicating a need among
caregivers for assistance in caring for disabled family members.

Guided primarily
by transitions theory, this study examined changes over two points
in time (approximately 5 years apart) in multiple life domains
(i.e., household tasks, social life, marital relationship, and
well-being) between two groups of husbands aged 60 and older,
who indicated that their wives were not in need of care or assistance
due to an illness or disability at the initial interview. The
two groups included husbands who identified themselves as a provider
of care at Time 2 (T2; i.e., they had transitioned into the caregiver
role; n = 26), and those married to healthy wives at T2 (i.e.,
noncaregivers; n = 262). Data came from a national probability
sample of U.S. adults who were primary respondents to the National
Survey of Families and Households in 1987-88, and who were followed
up longitudinally in 1992- 93. Findings suggested that husbands
who entered the caregiving role demonstrated significant changes
in household responsibilities, social integration, marital relationship,
and well-being. Implications for practice and future research
on the older husband caregiver are highlighted.

A
multimedia intervention to support family caregivers
EJ Hanson, J Tetley and A Clarke (1999) The Gerontologist,
Vol 39, Issue 6 736-741

The lack of
choice and predominance of crisis-oriented care in relation to
respite and long-term care for family carers and frail older people
provided the authors with the rationale for the development, within
the European-funded Assisting Carers using Telematic Interventions
to meet Older person's Needs (ACTION) project, of two innovative
multimedia programs. The key aim of the programs is to provide
education, information, and support about respite care and planning
for the future for family carers and frail older people in their
homes. In this way, it is intended that family carers and frail
older people will be able to make informed choices concerning
their health and social care needs. The authors describe the conceptual
basis of the multimedia programs, the research and development
process, the content of the multimedia programs, and the evaluation
of the developed product.

Gender
Differences in Psychiatric Morbidity Among Family Caregivers: A
Review and Analysis
JL Yee and R Schulz (2000) The Gerontologist 40:147-164

The major
goal of this article was to review and synthesize the empirical
research on caregiver gender and psychiatric morbidity, with the
aim of answering three questions: (a) Is there greater psychiatric
morbidity among female than male caregivers, (b) is the excess
psychiatric morbidity among female caregivers attributable to
caregiving, and (c) what factors in the caregiving situation contribute
to the excess psychiatric morbidity among female caregivers? In
almost all studies reviewed, women caregivers reported more psychiatric
symptoms than men caregivers. Comparisons with noncaregiving community
samples suggest that female caregivers experience excess psychiatric
morbidity attributable to caregiving. Using a stress process model
as an organizing framework, the study demonstrated that at all
stages of the stress process, women are at greater risk for psychiatric
morbidity than men. Directions for future research and implications
for interventions and public policy are discussed.

OBJECTIVES:
The purpose of this study was to investigate the predictors of
caregiver burden and depression, including objective stressors
and mediation forces influencing caregiving outcomes. METHODS:
This investigation is based on the 1994 Canadian Study of Health
and Aging (CSHA) database. Participants were 613 individuals with
dementia, living in either the community or an institution, and
their informal caregivers. Participants for the CSHA were identified
by screening a large random sample of elderly persons across Canada.
Structural equation models representing four alternative pathways
from caregiving stressors (e.g., functional limitations, disturbing
behaviors, patient residence, assistance given to caregiver) to
caregiver burden and depression were compared. RESULTS: The data
provided the best fit to a model whereby the effects on the caregiver's
well-being are mediated by appraisals of burden. A higher frequency
of disturbing behavior, caring for a community-dwelling patient,
and low informal support were related to higher burden, which
in turn led to more depressive symptomatology. Caregivers of patients
exhibiting more disturbing behaviors and functional limitations
received less help from family and friends, whereas those whose
care recipients resided in an institution received more informal
support. DISCUSSION: Our findings add to the preexisting literature
because we tested alternative models of caregiver burden using
an unusually large sample size of participants and after overcoming
methodological limitations of past research. Results highlight
the importance of the effective management of disturbing behaviors,
the provision of formal services for caregivers with highly impaired
patients and no informal support, and the improvement of coping
skills in burdened caregivers.

This prospective
study (n = 476) examined 3 types of caregiving transitions experienced
by wives and daughters of older persons: entry, institutionalization,
and bereavement. Daughters were more likely to enter the caregiving
role than wives, but the impact of entering the role was more
pronounced for wives. After becoming a caregiver, wives decreased
in their participation in leisure activities, perceptions of quality
of family relations, and marital satisfaction. Daughter caregivers
were more likely than wives to place their care recipient in an
institution, and they increased in social participation and decreased
in subjective burden after placement. Roughly the same percentage
of wife and daughter caregivers were bereaved during the study
period, and for wives bereavement was accompanied by an increase
in social involvement and personal growth. The results underscore
the highly dynamic nature of the caregiving career and the importance
of the kinship relationship between caregiver and care recipient
in conditioning the effects of caregiving transitions.

Purpose of
study: Mental health outcomes are widely reported among spouse
caregivers, with wives generally faring worse than husbands. We
hypothesized that gender differences would not be as strong in
a cognitively intact group because caring for cognitively intact
spouses may involve less severe reciprocity losses. We also examined
gender differences in coping strategies within each group. Design
and method: 175 spouse caregivers for patients with Alzheimer's
disease (AD; n = 88) and Parkinson's disease (PD; n = 87) were
interviewed. Participants completed perceived stress (PSS), depression
(CES-D), state anxiety (STAI, Form Y), and coping strategies (WCCL-R)
measures. Results: Wives in the AD group reported significantly
worse mental health outcomes than husbands, while wives and husbands
in the PD group showed no differences. AD caregiving wives were
less likely than husbands to use problem-focused coping strategies.
There were no significant gender differences in either group for
social support or emotion-focused coping. Implications:Loss of
reciprocity in marital relationships may affect women more negatively
than men. Future studies that address underlying mechanisms of
gender differences and focus on similar caregiving situations
and contexts deserve attention.

This study
describes patterns of caregiving experiences in partners of patients
with cancer (N=148) over a 6-month period. Caregiving experiences
were assessed by means of the Caregiver Reaction Assessment Scale
(CRA), which consists of four negative dimensions and one positive
subscale: Disrupted Schedule, Financial Problems, Lack of Family
Support, Loss of Physical Strength, and Self-Esteem. Subgroup
analyses were performed according to gender, age, and socioeconomic
status (SES). Type, size, and direction of changes in caregiving
experiences over time were analyzed both at a group level and
at an individual level. Patterns of caregiver experiences appeared
to vary between the subgroups; women, younger caregivers, and
caregivers with a higher SES experienced caregiving more negatively
or less positively. The findings illustrate the value of studying
inter- and intraindividual patterns across different subgroups,
and stress that caregiver experiences should be regarded as a
multidimensional concept that includes both negative and positive
experiences of caregiving.

Contextual
or General Stress Outcomes: Making Choices Through Caregiving Appraisals
V Braithwaite (2000) The Gerontologist 40:706-717

This study
contributes to the debate on general versus contextual measures
of caregiver well-being through examining the differential relationships
of caregiving appraisals to outcomes. Six dimensions of caregiving
appraisal were examined as predictors of minor psychiatric symptoms,
affect balance, and burden. Burden was high, symptoms were high,
and affect was poor when caregivers held appraisals that reflected
(a) low personal resiliency and (b) a conflict-ridden and dysfunctional
relationship with the care receiver. When caregivers reported
expending (c) considerable energy in maintaining their social
networks, burden was also high, with some risk of symptoms, but
affect was positive. The fourth appraisal, (d) a close loving
caregiver–care receiver relationship, was positively correlated
with general well-being, but was not related to burden. The fifth
appraisal, (e) dealing with a heavy workload in providing care,
was linked with poor affect, but neither symptoms nor burden.
Finally, (f) caring at a distance was related to burden, but not
to the general outcome measures. These findings suggest that the
foci of research questions might be usefully located within an
appraisal framework, and that this framework might then provide
guidance for the choice of appropriate outcome variables. In many
cases, however, a deeper understanding ensues from assessing both
contextual and general well-being.

Comparisons
of African American and White Women in the Parent Care Role
TM White, AL Townsend, and MA Parris Stephens (2000) The Gerontologist
40:718-728

Little is
known about African American women's experiences providing care
to impaired older relatives. This study investigated potential
differences in depressive symptomatology, parent care stress and
rewards, parent care mastery, and the quality of the parent care
relationship between 261 White and 56 African American daughters
and daughters-in-law who were providing care for an impaired parent
or parent-in-law. Multivariate analysis of variance, controlling
for significant background characteristics and interrelationships
among caregiving experiences, revealed that African American women
reported less stress and more rewards in the parent care role
than White women did. Race did not have a significant effect on
caregivers' depressive symptomatology, parent care mastery, or
the quality of their relationship with the parent. However, this
research demonstrates the importance of examining a broad range
of caregiving experiences in order to detect both similarities
and differences between African American and White caregivers.

A Randomized,
Controlled Trial of a Home Environmental Intervention: Effect on
Efficacy and Upset in Caregivers and on Daily Function of Persons
With Dementia
LN Gitlin, M Corcoran, L Winter, A Boyce, and WW Hauck (2001) The
Gerontologist 41:4-14

Purpose of
Study: The authors determined short-term effects of a home environmental
intervention on self-efficacy and upset in caregivers and daily
function of dementia patients. They also determined if treatment
effect varied by caregiver gender, race, and relationship to patient.
Design and Methods: Families (N = 171) of dementia patients were
randomized to intervention or usual care control group. The intervention
involved 5 90-min home visits by occupational therapists who provided
education and physical and social environmental modifi-cations.
Results: Compared with controls, intervention caregivers reported
fewer declines in patients' instrumental activities of daily living
(p = .030) and less decline in self-care and fewer behavior problems
in patients at 3 months post-test. Also, intervention spouses
reported reduced upset (p = .049), women reported enhanced self-efficacy
in managing behaviors (p = .038), and women (p = .049) and minorities
(p = .037) reported enhanced self-efficacy in managing functional
dependency. Implications: The environmental program appears to
have a modest effect on dementia patients' IADL dependence. Also,
among certain subgroups of caregivers the program improves self-efficacy
and reduces upset in specific areas of caregiving.

This study
examined interrole conflict experienced by 278 women who simultaneously
occupied 4 roles: parent care provider, mother to children at
home, wife, and employee. Compared with women who experienced
no conflict between parent care and their other roles, women reporting
parent care conflict tended to have fewer socioeconomic resources,
to have older children, and to be caring for parents with greater
impairment. Women who reported conflicts between parent care and
employment were older; had more education; had marriages of longer
duration; and had older, more self-sufficient children than women
who reported conflict between the parent care role and the mother
role. Some evidence was found for the hypothesis that interrole
conflict between parent care and other roles mediates the relationship
between parent care stress and psychosocial well-being. Results
suggest that one way parent care stress exerts its deleterious
effects on the well-being of adult daughters is through the incompatible
pressures of parent care and other roles.

Purpose: In
published dementia caregiver intervention research, there is widespread
failure to measure the level at which treatment was implemented
as intended, thereby introducing threats to internal and external
validity. The purpose of this article is to discuss the importance
of inducing and assessing treatment implementation (TI) strategies
in caregiving trials and to propose Lichstein's TI model as a
potential guide. Design and Methods: The efforts of a large cooperative
research study of caregiving interventions, Resources for Enhancing
Alzheimer's Caregiver Health (REACH), illustrates induction and
assessment of the three components of TI: delivery, receipt, and
enactment. Results: The approaches taken in REACH vary with the
intervention protocols and include using treatment manuals, training
and certification of interventionists, and continuous monitoring
of actual imple-mentation. Implications: Investigation and description
of treatment process variables allows researchers to understand
which aspects of the intervention are responsible for therapeutic
change, potentially resulting in development of more efficacious
and efficient interventions.

Purpose: This
study examined commonalities and differences in the experiences
and challenges of White, Black, and Hispanic informal caregivers
in New York, NY. Design and Methods: A randomly selected representative
cross-section of 2,241 households was contacted through telephone
interviews. Complete data were available for 380 eligible participants,
who were classified as White (n = 164), Black (n = 129) and Hispanic
(n = 87). Descriptive, bivariate, and multivariate analyses were
conducted to examine differences in caregiving intensity, reported
difficulty with providing care, and having unmet needs with care
provision. Results: Over 70% of caregivers had no help from formal
caregivers, even though over 80% had been providing care for at
least 1 year, and 40% had been providing this care for 20 or more
hr per week. Compared with White caregivers, Black caregivers
were more likely to provide higher intensity care, to report having
unmet needs with care provision, and to experience increased religiosity
since becoming caregivers, but were less likely to report difficulty
with providing care. Hispanic caregivers were more likely than
White caregivers to have help from formal caregivers and to experience
increased religiosity since becoming caregivers. Implications:
Although many similarities exist in the experiences and challenges
of informal caregivers, gaining insight from different populations
of family caregivers would help program planners, policy makers,
and formal caregivers to develop and implement culturally sensitive
programs and policies that are supportive of the needs of these
caregivers in their ever-expanding roles. Future efforts also
should focus on exploring the potentially significant role that
community resources, in particular, religious institutions, could
play in providing outreach and support to racial/ethnic minority
caregivers.

The
Effects of Nursing Home Placement on Family Caregivers of Patients
With Alzheimer's Disease
MA Lieberman and L Fisher (2001) The Gerontologist 41:819-826

Purpose: This
study sought to determine the effects of nursing home placement
(NHP) for patients with Alzheimer's disease, compared to maintaining
community placement, on changes in family caregiver health and
well-being over time. Design and Methods: We utilized a 2-year,
longitudinal study with one baseline and four follow-up assessments
for patients' spouses, adult offspring, and in-laws (married to
offspring). Families were recruited from eight clinical outpatient
centers, supported by the State of California, and followed in
the community over time. A multidisciplinary clinical evaluation
was undertaken by the centers, and follow-up assessments included
questionnaire and interview data. Results: Family caregiver health
and well-being did not improve over time following NHP, and there
were no significant differences in health and well-being between
family caregivers who placed their ill elder in a nursing home
and those who kept the elder at home or in the community. However,
female family caregivers and spouses displayed greater declines
in health and well-being over time, compared to other family caregivers,
regardless of whether or not NHP occurred. Implications: Families
considering NHP need to be advised of what may and may not change
following NHP. In particular, spouses and female family caregivers
may not experience those changes in life satisfaction and well-being
that are hoped for. Variation in the effects of NHP may be more
related to pre-NHP family processes and relationships than to
the severity of the patient's disability, caregiver strain, patient
and caregiver demographics, and use of community-based professional
services.

Self-Gain
and Self-Loss Among African American and White Caregivers
K Long Foley, HJ Tung and EJ Mutran (2002) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 57:S14-S22

Objectives.
This study compared the effects of a traditional ideology of care
and role conflict on the intrinsic rewards (self-gain) and consequences
(self-loss) of caregiving among African Americans and Whites.
Methods. Using a cross-sectional telephone survey of caregivers
in North Carolina (n = 481), the authors performed a structural
equation groups analysis to assess the equality of an a priori
caregiving model for African Americans (n = 257) and Whites (n
= 224). Results. Despite a stronger preference for family care
among African Americans, traditional caregiving ideology was associated
with more self-gain among Whites only; there was no relationship
between preference for family care and self-loss for either group.
Furthermore, role conflict was unrelated to self-gain but was
related to more self-loss for both groups. Three additional relationships
differed between African Americans and Whites: age and self-gain,
gender and self-gain, and care recipient depression and role conflict.
However, 12 proposed relationships were statistically significant
and equivalent for African Americans and Whites. Discussion. The
findings suggest that contextual elements that influence preference
for family care and role conflict are almost identical for African
Americans and Whites. Caregiver demographics are associated with
caregiving ideology, whereas care recipient frailty is related
to role conflict. However, there are differences between African
American and White caregivers, which primarily stem from the role
of age, gender, and preference for family care with self-gain.

Two samples
of family caregivers (Study 1: N = 169; Study 2: N = 145) of cognitively
impaired older adults were used to revise, extend, and evaluate
a measure of perceived self-efficacy for caregiving tasks. The
Revised Scale for Caregiving Self-Efficacy measures 3 domains
of caregiving self-efficacy: Obtaining Respite, Responding to
Disruptive Patient Behaviors, and Controlling Upsetting Thoughts.
The 3 subscales show strong internal consistency and adequate
test–retest reliability. Construct validity is supported
by relationships between these 3 facets of perceived caregiving
efficacy and depression, anxiety, anger, perceived social support,
and criticism expressed in speech samples. The Revised Scale for
Caregiving Self-Efficacy has potential uses for both research
and clinical purposes.

Neighbors,
Friends, and Other Nonkin Caregivers of Community-Living Dependent
Elders
JC Barker (2002) The Journals of Gerontology Series B: Psychological
Sciences and Social Sciences 57:S158-S167

Objectives.
To describe naturally occurring care relationships between unpaid,
nonprofessional, nonkin (unrelated) caregivers and frail community-living
older adults. Methods. Face-to-face, semistructured interviews
were conducted with a convenience sample of 114 caregivers and
care recipients recruited from the community through a variety
of organizations. Standard techniques for thematic analysis of
qualitative data were used along with descriptive and other statistics
as appropriate for numerate data. Results. Nonkin caregiving proved
to be heterogeneous in initiation of relationship, form, duration,
tasks performed, and association with family caregivers. Partnerships
ranged from 0.1 to 57 years in duration, with just over half (58%)
starting with the provision of care. Many caregivers (47%) were
themselves older adults, aged 65 or older. There was little variation
in what motivated or rewarded caregivers, many of whom felt morally
obligated to help. More than half the sample used kin terms to
characterize their relationship. Four distinct styles of relationship
were discerned, varying by degree of emotional intimacy and types
of assistance given. All relationships, however, involved socializing
and help with at least two instrumental tasks of daily life. Discussion.
This kind of caregiving is important for sustaining community
living for about 10% of frail elderly persons. A greater understanding
is needed, from both theoretical and practical perspectives, of
when and how nonkin relationships are beneficial and why they
in many ways successfully mirror the actions and sentiments of
family caregivers.

Objectives.
Little is known regarding the amount of time spent by unpaid caregivers
providing help to elderly individuals for disabilities associated
with diabetes mellitus (DM). We sought to obtain nationally representative
estimates of the time, and associated cost, of informal caregiving
provided to elderly individuals with diabetes, and to determine
the complications of DM that contribute most significantly to
the subsequent need for informal care. Methods. We estimated multivariable
regression models using data from the 1993 Asset and Health Dynamics
Among the Oldest Old Study, a nationally representative survey
of people aged 70 or older (N = 7,443), to determine the weekly
hours of informal caregiving and imputed cost of caregiver time
for community-dwelling elderly individuals with and without a
diagnosis of DM. Results. Those without DM received an average
of 6.1 hr per week of informal care, those with DM taking no medications
received 10.5 hr, those with DM taking oral medications received
10.1 hr, and those with DM taking insulin received 14.4 hr of
care (p < .01). Disabilities related to heart disease, stroke,
and visual impairment were important predictors of diabetes-related
informal care. The total cost of informal caregiving for elderly
individuals with diabetes in the United States was between $3
and $6 billion per year, similar to previous estimates of the
annual paid long-term care costs attributable to DM. Discussion.
Diabetes imposes a substantial burden on elderly individuals,
their families, and society, both through increased rates of disability
and the significant time that informal caregivers must spend helping
address the associated functional limitations. Future evaluations
of the costs of diabetes, and the cost-effectiveness of diabetes
interventions, should consider the significant informal caregiving
costs associated with the disease.

Caregiving
as a Dyadic Process: Perspectives from Caregiver and Receiver
KS Lyons, SH Zarit, AG Sayer and CJ Whitlatch, (2002) The Journals
of Gerontology Series B: Psychological Sciences and Social Sciences
57:P195-P204

Most family
caregiving research has relied on the perspective of the caregiver
but has not systematically examined the views and opinions of
the elder who is receiving care. The present study examined 63
caregiving dyads to determine how the responses of each member
had an impact on the well-being of the other member of the dyad.
Caregiver relationship strain predicted his or her own depression
and negative health, but no significant association was found
between caregiver and care recipient outcomes. Multilevel modeling
was used to assess the level of dyadic discrepancy over the care
recipient's needs and appraisal of caregiving difficulties. Results
indicate that there is little disagreement over the care recipient's
needs, but a significant amount of variation in how much the care
recipient and caregiver agree on their appraisals of caregiving
difficulties. Relationship strain perceived by the caregiver,
but not the care recipient, was significantly associated with
this disagreement.

Coping
and Depression in Alzheimer's Caregivers: Longitudinal Evidence
of Stability
DV Powers, D Gallagher-Thompson and HC Kraemer (2002) The Journals
of Gerontology Series B: Psychological Sciences and Social Sciences
57:P205-P211

The present
study examined the longitudinal relationship between depressive
symptoms and coping strategies in older adult primary caregivers
of noninstitutionalized Alzheimer's patients. Coping and depression
were measured in 51 healthy, nondepressed caregivers (37 women,
14 men) at 4 times of testing approximately 6 months apart. The
caregivers' coping strategies and depressive symptoms were found
to be largely stable over all times of testing—with a recently
developed method for evaluating construct stability—despite
significant decline in the patients' cognitive functioning over
the same interval. Avoidance coping was also found to be positively
associated with depressive symptoms. Results suggest that a strong
stable component is present in caregiver coping style and that
caregiver intervention researchers may want to examine the extent
to which commonly used outcome measures are assessing stable caregiver
traits rather than state-dependent distress.

Purpose: The
purpose of this study was to evaluate burden experienced by a
group of American Indian primary family caregivers and to determine
if caregiver burden is a multidimensional concept. Design and
Methods: This analysis is based on the results of a survey questionnaire
administered to 169 Pueblo primary family caregivers in New Mexico.
Results: Analysis of the items composing the Caregiver Burden
scale indicated that caregiver burden is multidimensional and
consists of several types of burden. Caregiver burden, as identified
in this sample, is composed of four dimensions: role conflict,
negative feelings, lack of caregiver efficacy, and guilt. Investigations
of caregiver burden should consider the multidimensionality of
this experience and evaluate burden accordingly. Implications:By
identifying the specific type of burden that a caregiver experiences,
interventions can be targeted more accurately to support family
caregiving.

Purpose: This
study adapts the Stress Process Model (SPM) of family caregiving
to examine the predictors of depression in a sample of caregivers
(n = 133) with demented relatives residing in suburban skilled
nursing facilities. Design and Methods: We interviewed family
caregivers of family members residing in skilled nursing homes
using a variety of measures to assess primary stressors, secondary
strain, nursing home stressors, and caregiver depression. We used
block-wise regression analyses to determine the predictors of
caregiver de-pression. Results: Results indicated that positive
resident adjustment to placement was best predicted by the closeness
of the resident–caregiver relationship and nursing home
stressors. Caregiver strain, resident adjustment, and nursing
home stressors best predicted caregiver adjustment. In turn, the
best predictors of caregiver depression included caregiver age,
caregiver adjustment to the nursing home, and nursing home stressors.
Implications:These results suggest that caregiver depression is
closely linked to how well both the resident and caregiver adjust
to the nursing home environment. Results also indicate that by
broadening the SPM to include stressors common to the nursing
home experience, researchers will be able to understand more clearly
the specific components of the stress process that may lead to
depression in family caregivers of persons living in nursing homes.

Burden
Among Family Caregivers of Persons With Alzheimer's Disease in Nursing
Homes
JB Tornatore and LA Grant (2002) The Gerontologist 42:497-506

Purpose: This
article examines family caregiver burden after placement of a
relative with Alzheimer's disease or a related dementia in a nursing
home. Design and Methods: A systems-oriented contextual approach
was used to study burden in 276 family caregivers. Results: SAS
PROC MIXED analysis showed burden to be associated with caregiver
age, length of time involved in caregiving, custodial units, involvement
in hands-on care, and expectations for care. Implications: The
findings suggest that more services aimed at relieving caregiver
burden after nursing home placement may be warranted, particularly
so for caregivers who are older and for those who had a shorter
length of involvement in direct caregiving before institutionalization.

The
Influence of Parental Bonding on Emotional Distress in Caregiving
Sons for a Parent with Dementia
AP Daire (2002) The Gerontologist 42:766-771

Purpose: The
purpose of this study was to investigate the influence of childhood
parental bonding on emotional distress experienced by primary
caregiving sons for a parent with dementia. Design and Methods:
Data from the 40 participants were obtained using the Parental
Bonding Inventory (PBI), Brief Symptom Inventory (BSI), and Caregiver
Survey Questionnaire (CSQ). A multivariate analysis of variance
was conducted to investigate any main effects or interaction between
the two PBI bonding variables (care and overprotection) and the
two distress variables, the BSI's Global Severity Index and the
CSQ's distress percentage. Results: Caregiving sons who identified
more care in the childhood bond with their parent attributed less
distress to their primary caregiver role. Sons reporting less
care attributed more distress to the primary caregiver role. Implications:
Results suggest that the parental bond developed during childhood
may play a role in predicting the extent to which caregiving sons
will attribute distress to their caregiving role.

Purpose: This
study assessed overall quality of life of caregivers, using a
path model in which burden was conceptualized as distinct from
well-being. Design and Methods: Data were drawn from a representative
sample of caregivers to dementia and nondementia care receivers
in British Columbia, Canada (N = 243). The model used was based
on a previously proposed stress/appraisal path model and used
multiple regression path estimates. Primary stressors were care
receiver cognitive status, physical function, and behavioral problems;
the primary appraisal variable was hours of caregiving during
the previous week. Mediators were perceived social support, frequency
of getting a break, and hours of formal service use; secondary
appraisal was subjective burden. The outcome measure was generalized
well-being. Results:Well-being was directly affected by four variables:
perceived social support, burden, self-esteem, and hours of informal
care. Burden was affected directly by behavioral problems, frequency
of getting a break, self-esteem, and informal hours of care and
was not affected by perceived social support. Discussion: The
finding that perceived social support is strongly related to well-being
but unrelated to burden reinforces the conceptual distinctiveness
of the latter two concepts. This suggests that quality of life
of caregivers could be improved even with burden in their lives
and that the overwhelming focus in caregiving research on burden
should be supplemented with an emphasis on quality of life.

Multiple
Role Occupancy in Midlife: Balancing Work and Family Life in Britain
M Evandrou, K Glaser and U Henz (2002) The Gerontologist
42:781-789

Purpose: This
article investigates the extent of multiple- role occupancy among
midlife individuals in Britain in cross-section and over the life
course, focusing on work and family commitments. The association
between demographic and social factors and multiple-role obligations
is also investigated. Design and Methods: The research is based
on secondary analysis of the British Family and Working Lives
Survey, which contains retrospective paid work, caregiving, and
child coresidence histories. Results: The proportion of individuals
in midlife (women aged 45–59 and men aged 45–64) who
have multiple roles, in terms of paid work and consistent family
care, at any one point in time is low (2%). This is primarily
due to the relatively small proportion (7%) of people in this
age group who are caring for a dependent. Being older, unmarried,
and in poor health significantly reduces the number of roles held
among men and women. Although the frequency of multiple role occupancy,
and intensive multiple role occupancy, is low on a cross-sectional
basis, a much higher proportion of individuals have ever occupied
multiple roles over their life course (14%). Implications: The
findings will inform debate on how policy can best aid those endeavouring
to balance paid work, family life, and caring responsibilities.

Evaluation
of Geriatric Day Care Units: Effects on Patients and Caregivers
S Zank and C Schacke (2002) The Journals of Gerontology Series
B: Psychological Sciences and Social Sciences 57:P348-P357

The aim of
this study was to evaluate the effects of geriatric day care on
patients and caregivers. Day care patients (n = 43) were compared
with an untreated matched control group (n = 40). Matching criteria
were age, gender, physical and mental health status, and socioeconomic
status. The mean age of both groups was 79.5 years. Data were
collected at three measurement points: T1 took place during the
first 10 days of service use, T2 was conducted 6 months later,
and T3 took place 9 months after service use began. In addition,
a short follow-up was conducted 6 months after T3. Well-being,
dementia symptoms, health indicators, and activities of daily
living were investigated. Individual growth curves of these patient
variables were computed and analyzed with multivariate analyses
of variance. The results show significant positive effects of
day care on well-being and dementia symptoms. Patients in day
care stabilized or improved on various measures, whereas the untreated
control participants worsened. Follow-up data showed a significant
decline in health in the control group in comparison with the
day care users. Results concerning effects on caregivers were
not that clear. Individual change parameters in subjective well-being
and burden did not differ between the two groups of caregivers
in the longitudinal follow-up. In a semistructured interview,
however, caregivers of patients in the treatment group reported
substantial positive change due to use of day care.

The
Gendered Nature of Men's Filial Care
LD Campbell and A Martin-Matthew (2003) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 58:S350-S358

Objectives.
This paper investigates sociodemographic and family structure
factors that predict men's involvement (n = 773) in different
gendered dimensions of filial caregiving: traditionally male,
gender neutral, and traditionally female care. Methods. The concepts
that guide this research relate to family obligations or motivations
to provide care, specifically, commitment to care, legitimate
excuses, and caring by default. Data for this research come from
the Work and Family Survey (1991–1993) conducted by the
Work and Eldercare Research Group of CARNET: The Canadian Aging
Research Network. Results. Although such factors as geographic
proximity and sibling network composition predict men's involvement
independent of the type of task, the gendered nature of the task
is important in how other factors, such as filial obligation,
parental status, education, and income influence involvement in
care. Discussion. The findings suggest that, for traditionally
male tasks, legitimate excuses or a commitment to care may play
a more minor role in influencing men's involvement than is true
for traditionally female tasks. Overall, this research demonstrates
the importance of examining the gendered nature of the care tasks
and highlights the value of the conceptual framework for explaining
variations in men's filial care.

Purpose: This
article reviews and critiques several issues of importance to
those whose goal is to make intervention research with Latino
caregivers more "user-friendly." Issues range from current
demographic trends showing the ever-increasing number of Latino
caregivers to discussion of cultural values that influence their
help-seeking behavior. Design and Methods: This article presents
a review of current published information on this topic. The gerontological
literature was searched for the past decade for relevant material;
in addition, the authors' own experience in this area is described.
Results: Although limited information was found that derived from
actual empirical studies, a number of articles describe potential
barriers to research involvement and provide suggestions for making
participation more attractive and culturally appropriate for Latinos.
Implications: Clinical researchers need to increase their sensitivity
to such issues as cultural values and language preference and
develop effective collaborations with the Latino community so
that intervention research programs can be designed and implemented
successfully with Latinos caring for cognitively impaired elderly
family members at home.

Associations
of Stressors and Uplifts of Caregiving With Caregiver Burden and
Depressive Mood: A Meta-Analysis
M Pinquart and S Sörensen (2003) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 58:P112-P128

In the present
meta-analysis, we integrated findings from 228 studies on the
association of six caregiving-related stressors and caregiving
uplifts with burden and depressed mood. Care recipients' behavior
problems showed stronger associations with caregiver outcomes
than other stressors did. The size of the relationships varied
by sample characteristics: Amount of care provided and care receivers'
physical impairments were less strongly related to burden and
depression for dementia caregivers than for caregivers of nondemented
older adults. For spouse caregivers, physical impairments and
care recipients' behavior problems had a stronger relationship
to burden than for adult children. Furthermore, we found evidence
that the association of caregiver burden with the number of caregiving
tasks, perceived uplifts of caregiving, and the level of physical
impairment of the care receiver were stronger in probability samples
than in convenience samples.

Purpose: This
study describes transitions over 5 years among community-dwelling
elderly spouses into and within caregiving roles and associated
health outcomes. Design and Methods: Participants in the Caregiver
Health Effects Study (n = 818) were interviewed four times over
5 years with changes in their caregiving status described. Analyses
of the effect on health outcomes of transitions were performed
on those for whom four observations were available (n = 428).
Results: Only half (49.5%) of noncaregivers at baseline remained
noncaregivers at 5-year follow-up. The remainder experienced one
or more transitions, including moving into the caregiving role,
their own or their spouse's death, or placement of their spouse
in a long-term care facility. The trajectory of health outcomes
associated with caregiving was generally downward. Those who transitioned
to heavy caregiving had more symptoms of depression, and poorer
self-reported health and health behaviors. Implications: Transitions
into and within the caregiving role should be monitored for adverse
health effects on the caregiver, with interventions tailored to
the individual's location in the caregiving trajectory.

Exploring
the Issues of Race, Ethnicity, and Culture in Caregiving Research:
A 20-Year Review (1980–2000)
P Dilworth-Anderson, I Canty Williams, and BE Gibson (2002) The
Gerontologist 42:237-272

Purpose: The
goals of this review are to synthesize what is known about caregiving
among diverse groups and to identify gaps in knowledge to guide
future research on caregiving. The review focuses on conceptual
and theoretical approaches, sampling strategies, measurement techniques,
and similarities and differences found among groups and across
studies. Design and Methods: A narrative approach was used to
review 59 articles published between 1980 and 2000, with particular
attention to race, ethnicity, and/or culture. Primary sources
of relevant articles included electronic databases, other review
articles, and reference lists. Results: Caregiving experiences
and outcomes varied across racial and ethnic groups. However,
the use of nontheoretical approaches, nonprobability samples,
and inconsistent measures among studies has limited understanding
of caregiving among diverse populations. Implications: It is important
that conceptualization and theorizing broaden with increasing
numbers of studies that include diverse groups. Future caregiving
research needs to give more attention to such issues as acculturation,
assimilation, and cultural values, beliefs, and norms, while also
improving theoretical and methodological rigor.

Purpose: We
examined the impact of caregiver neuroticism on longitudinal change
in depression among spouse-caregivers of individuals with Alzheimer's
disease receiving either enhanced psychosocial treatment or usual
care. We were interested in whether high levels of caregiver neuroticism
would lead to a diminished response to the enhanced treatment
and whether neuroticism affected the longitudinal course of caregiver
depression regardless of intervention. Design and Methods: We
analyzed data from the NYU Spouse-Caregiver Intervention Study,
which randomly assigned caregivers either to an enhanced treatment
group that received a comprehensive intervention with counseling,
support, and consultation, or to a usual-care control group. The
present study analyzed data from 320 caregivers, 160 in each group,
who completed the NEO questionnaire. We used random-effects growth
curve modeling to examine changes in depression in the first year
after intake, examining possible effects of neuroticism on the
course of caregiver depression and on response to intervention.
Results: Caregivers high in neuroticism showed a worse longitudinal
course of depression compared with those low in neuroticism in
both the enhanced treatment and usual-care groups after we adjusted
for baseline depression as a covariate. Caregivers showed benefits
from the enhanced treatment compared with usual care, regardless
of neuroticism score. However, caregivers low in neuroticism responded
to treatment with declining levels of depression, whereas caregivers
high in neuroticism maintained their baseline level of depression.
Implications: Caregiver neuroticism is a risk factor for increased
caregiver depression over time. High neuroticism does not preclude
successful caregiver intervention with a highly individualized
intervention like ours, but expectations of outcome should be
different than for caregivers low in neuroticism. Future studies
should investigate the relationship between neuroticism and response
to less individualized interventions and the impact of other personality
characteristics on response to treatment.

Purpose: This
study examines gender differences in spousal caregiver stress
associated with care-recipient problem behaviors and helping behaviors.
Design and Methods: Using data from the National Long-Term Care
Survey, we examined bivariate and multivariate relationships between
the behaviors of care recipients and the stress experienced by
their spouses. Results: Gender differences in caregiver stress
emerged with respect to problem behaviors and helping behaviors
of the care recipient. Helping behaviors had a moderating effect
on the relationship between care-recipient problem behaviors and
stress for caregiving husbands, but not for caregiving wives.
Implications: As practitioners attempt to reduce spousal caregiving
distress, they should assess the extent to which care recipient's
problem behaviors and efforts to be helpful contribute to caregiver
stress.

A
Study of 10 States Since Passage of the National Family Caregiver
Support Program: Policies, Perceptions, and Program Development
L Friss Feinberg and SL Newman (2004) The Gerontologist
44:760-769

Purpose: This
study describes the preliminary experiences of 10 states in providing
support services to family or informal caregivers of elderly adults
and adults with disabilities; it focuses on the newly created
National Family Caregiver Support Program, state general funds,
Medicaid-waiver programs, and other state-funding streams. Design
and Methods: Case studies were conducted, between March and July
2002, through in-person interviews with state officials and stakeholders
in Alabama, California, Florida, Hawaii, Indiana, Iowa, Maine,
Pennsylvania, Texas, and Washington. Results: States were in the
start-up phase of implementing the National Family Caregiver Support
Program and varied greatly in program design and integration of
caregiver support into their home- and community-based care system.
Viewing family caregivers as a client population was a paradigm
shift for many state officials. Implications: Heavy reliance is
currently placed on family and informal caregivers in home- and
community-based care, without adequate support services. Family
support should be an explicit goal of long-term-care system reform.

Identifying
Changeable Barriers to Family Involvement in the Nursing Home for
Cognitively Impaired Residents
C Lindman Port (2004) The Gerontologist 44:770-778

Purpose: Barriers
to family involvement in the nursing home with the potential for
change through intervention are examined, including transportation,
caregiver health, relationships with staff, and resident characteristics.
Design and Methods: Data were collected for 93 family caregiver–resident
pairs by means of telephone interviews and chart review. Regression
modeling was used to identify relationships between involvement
(caregiver visit frequency) and the changeable barriers after
the known variables of distance, kinship, payment source, length
of stay, and cognitive function were taken into account. Results:
Lower visit frequency was found for caregivers reporting problems
with transportation, poor relationships with staff, and a smaller
network of supportive family and friends. Higher caregiver anxiety
was related to higher visit frequency. Implications: Several barriers
to family involvement are shown to be as or more influential than
ones identified in previous research, thus providing empirical
support for interventions currently used as well as suggesting
new areas for intervention.

Purpose: This
study examines depressive symptoms among adult children of elderly
parents; it views the parents' care needs and child's care activities
as two separate stressors, different combinations of which may
affect both caregiving and noncaregiving family members. Design
and Methods: A sample of 4,380 women and 3,965 men from the first
wave of the Health and Retirement Study was analyzed by use of
four alternative forms of multiple regression analysis. Using
the Center for Epidemiological Studies Depression scale, respondents
reported on their depressive symptoms, as well as on parental
disability and care provided by themselves, their spouses, and
siblings. Results: Noncaregivers reporting severe parental disability
were significantly more likely to experience depression symptoms.
Evidence of increased manifestations of depression was not found
among those caring for severely disabled relatives; nor was it
found among those providing care in the absence of severe parental
care needs. Having a caregiving sibling was associated with increased
CES-D scores among noncaregivers. Implications: In the current
literature, personal care needs of a close relative are named
among significant disturbances in the lives of caregivers. By
extending this approach to members of a family network regardless
of caregiver status, this study allows us to distinguish the magnitude
of negative outcomes of serious parental care needs while clarifying
the impact uniquely attributable to caregiving activities.

Effects
of a Caregiver Intervention on Negative Caregiver Appraisals of
Behavior Problems in Patients With Alzheimer's Disease: Results
of a Randomized Trial
MS Mittelman, DL Roth, WE Haley and SH Zarit (2004) The Journals
of Gerontology Series B: Psychological Sciences and Social Sciences
59:P27-P34

Behavioral
problems are among the most challenging aspects of caring for
a person with Alzheimer's disease. A sample of 406 spouses–caregivers
of patients with Alzheimer's disease was randomized to an active
multicomponent counseling and support intervention condition or
to a usual care condition. Caregivers reported on the frequency
of troublesome patient behaviors and their reactions to them at
baseline and at regular follow-up interviews. Random-effects regression
models over the first 4 years after randomization revealed that,
although the intervention did not affect the frequency of patient
behavioral problems, it did significantly reduce caregivers' reaction
ratings. Because caregiver appraisals have been found to mediate
the impact of caregiving stress on depression and to predict nursing
home placement rates, they deserve greater attention as an important
target of intervention services.

Can
Culture Help Explain the Physical Health Effects of Caregiving Over
Time Among African American Caregivers?
P Dilworth-Anderson, PY Goodwin and S Wallace Williams (2004) The
Journals of Gerontology Series B: Psychological Sciences and Social
Sciences 59:S138-S145

Objectives.
The purposes of this study were to longitudinally examine the
health outcomes of 107 African American caregivers who provided
care to their elderly dependent family members and to determine
the role of culture in predicting health outcomes. Methods. With
use of the stress and coping model of Pearlin and colleagues (1990)
as a guide, the direct effects of background characteristics and
stressors and the direct and mediating effects of resources (including
culture) on two caregiver health outcomes (i.e., psychosocial
health and physical functioning) were analyzed with hierarchical
multiple regression analyses. Results. Similar to other studies,
we found that combinations of caregiver background characteristics,
stressors, and resources at wave 1 had direct effects on African
American caregivers' health outcomes at wave 3. Unlike previous
studies, where culture was not measured, we found that cultural
beliefs and values did help to explain health outcomes for African
American caregivers. Specifically, culture justifications for
caregiving, baseline psychosocial health, and caregiving mastery
predicted wave 3 psychosocial health. Caregiver education, number
of morbidities, and physical functioning at wave 1 were associated
with physical functioning at wave 3. Discussion. The findings
from this study have implications for future studies, particularly
in regard to cultural beliefs and values among African American
caregivers.

Longitudinal
Changes in the Well-Being of Japanese Caregivers: Variations Across
Kin Relationships
Y Sugihara, H Sugisawa, Y Nakatani and GW Hougham (2004) The
Journals of Gerontology Series B: Psychological Sciences and Social
Sciences 59:P177-P184

This study
examined how the psychological well-being of Japanese caregivers
changed over time; it also examined the variation across kin relationships
with care recipients. Three interviews over the course of 30 months
were conducted with a representative sample of community-dwelling
caregivers of frail elderly persons living in a Tokyo suburb.
Latent growth modeling demonstrated that mean levels of both depression
and emotional exhaustion worsened over time. Change in emotional
exhaustion over time showed significant individual variability,
whereas change in depression showed little individual variability.
Although wife caregivers tended to experience the worst trajectory
of emotional exhaustion, daughters-in-law also showed a similar
negative trend. The difference in individuals' well-being trajectories
by kinship may be explained partly by differences in care recipients'
disabilities.

We examined
differences in positive aspects of caregiving (PAC) among 275
African American and 343 Caucasian caregivers of individuals with
Alzheimer's disease from the National Institutes of Health Resources
for Enhancing Alzheimer's Care Health (REACH) study sites in Birmingham,
Memphis, and Philadelphia. African Americans reported higher scores
on PAC than did Caucasians. African Americans' higher religiosity
partially mediated the relationship between race and PAC. Additional
variables that contributed to their higher PAC scores were African
Americans' lower anxiety, lower feelings of bother by the care
recipient's behavior, and lower socioeconomic status.

From
Caregiving to Bereavement: Trajectories of Depressive Symptoms Among
Wife and Daughter Caregivers
LW Li (2005) The Journals of Gerontology Series B: Psychological
Sciences and Social Sciences 60:P190-P198

This study
examined the trajectory of depressive symptoms for wife and daughter
caregivers during the transition from caregiving to bereavement,
and it investigated whether the trajectory varies by caregivers'
caregiving stress, social support, and background characteristics.
Hierarchical linear modeling was used to analyze four-wave longitudinal
data collected from 157 wife and daughter caregivers who lost
elderly relatives to death. Results show that, on average, caregivers
experience increasing depressive symptoms as their care recipients
approach death, and they experience decreasing symptoms after.
Care recipients' problematic behavior and caregivers' kinship,
income, and feelings of overload moderate the change in depressive
symptoms during the transition. Services to support caregivers
should target specific groups of caregivers, based on caregiving
experience and background characteristics, at times when they
are most in need.

Ethnic
Differences in Stressors, Resources, and Psychological Outcomes
of Family Caregiving: A Meta-Analysis
M Pinquart and S Sörensen (2005) The Gerontologist
45:90-106

Purpose: We
investigated ethnic differences in caregiver background variables,
objective stressors, filial obligations beliefs, psychological
and social resources, coping processes, and psychological and
physical health. Design and Methods: We used a meta-analysis to
integrate the results of 116 empirical studies. Results: Ethnic
minority caregivers had a lower socioeconomic status, were younger,
were less likely to be a spouse, and more likely to receive informal
support. They provided more care than White caregivers and had
stronger filial obligations beliefs than White caregivers. Asian-American
caregivers, but not African-American and Hispanic caregivers,
used less formal support than non-Hispanic White caregivers. Whereas
African-American caregivers had lower levels of caregiver burden
and depression than White caregivers, we found that Hispanic and
Asian-American caregivers were more depressed than their White
non-Hispanic peers. However, all groups of ethnic minority caregivers
reported worse physical health than Whites. Observed ethnic differences
in burden and depression were influenced by study characteristics,
such as the type of illness of the care recipient and the representativeness
of the sample. Implications: The results suggest that more specific
theories are needed to explain differential effects of ethnic
minority groups of caregivers. Intervention needs vary, in part,
between ethnic groups of caregivers.

Investigating
the Effects of Communication Problems on Caregiver Burden
MY Savundranayagam, M Lee Hummert and RJV Montgomery (2005) The
Journals of Gerontology Series B: Psychological Sciences and Social
Sciences 60:S48-S55

Objectives.
The goal of this study was to explore the relationship between
communication problems associated with dementia and caregiver
burden, within the context of problem behaviors and cognitive
and functional abilities of the care recipient. Methods. A scale
on communication problems associated with dementia was developed
and administered to 89 family caregivers. Participants also completed
measures of care-recipient cognitive and functional status, problem
behavior, and caregiver burden (demand, stress, and objective
burden). Results. Analyses using structural equation modeling
showed that care-recipient cognitive and functional status indirectly
predicted problem behaviors via communication problems. The status
indicators also directly predicted demand burden. In addition,
problem behaviors mediated the relationship between communication
problems and all forms of burden. Discussion. The study findings
not only lend further support to the existing literature that
has documented problem behaviors as strong predictors of burden
but also emphasize the importance of communication problems in
the caregiving process.

COMMUNITY
SERVICE AND VOLUNTEERING

Volunteering
and mortality among older adults: Findings from a national sample
MA
Musick, AR Herzog and JS House (1999) Journals of GerontologySeries B: Psychological Sciences and Social Sciences, Vol
54, Issue 3, S173-S180

OBJECTIVES:
Although a number of authors have proposed that older volunteers
should benefit in terms of better health and well-being, few researchers
have examined the issue empirically to see whether this is true.
The purpose of this article is to build on this literature by
empirically examining the association between volunteering and
mortality among older adults. METHODS: Using data from a nationally
representative sample, we use Cox proportional hazards regression
to estimate the effects of volunteering on the rate of mortality
among persons aged 65 and older. RESULTS: We find that volunteering
has a protective effect on mortality among those who volunteered
for one organization or for forty hours or less over the past
year. We further find that the protective effects of volunteering
are strongest for respondents who report low levels of informal
social interaction and who do not live alone. DISCUSSION: We discuss
the possibility that the curvilinear relationship we observe between
volunteering and mortality is due to a combination of factors,
including self-identity, role strain, and meaningfulness. Other
research using more precise data is needed to determine whether
these ideas are supportable.

Intergenerational
visitation programs have demonstrated advantages for the young
and old, but few programs last more than a year or two. Weaving
long-term intergenerational programs into the fabric of both school
curricula and community cultural life was the goal of a project
launched in 1988 in Phoenix, Arizona. Classrooms of children visit
weekly or biweekly with nearby nursing home residents, developing
friendships while pursuing educational activities. Carefully planned
and widespread community support through board participation,
donations, and publicity has allowed the program to continue to
expand, while the budget has decreased. Materials are available
which facilitate program replication.

Giving
Social Support to Others, Socioeconomic Status, and Changes in Self-Esteem
in Late Life
N Krause and BA Shaw (2000) The Journals of Gerontology Series
B: Psychological Sciences and Social Sciences 55:S323-S333

Objective.
The purpose of this study was twofold: (1) to see if providing
emotional support to others bolsters the self-esteem of older
adults over time; and (2) to assess whether the salubrious effects
of helping others are more likely to be enjoyed by high socioeconomic
status (SES) elders. Methods. Interviews were conducted with a
nationally representative sample of older adults at three points
in time: 1992–1993, 1996–1997, 1998–1999. Complete
data are available for 511 elderly people. During each round of
interviews, respondents were asked how often they provided emotional
support to their social network members. Information on the self-esteem
of older support providers was also gathered at each point in
time. Results. Initially, the findings revealed that helping others
tends to bolster the self-esteem of all study participants regardless
of their SES standing. However, these benefits began to taper
off for lower SES elders during the course of the study. By the
third wave of interviews, the salutary effects of helping others
were evident only among older adults in upper SES levels. Discussion.
The results highlight the dynamic nature of the helping process
and underscore the importance of taking SES into account when
studying the effects of assisting others in late life.

Differential
Benefits of Volunteering Across the Life Course
M Van Willigen (2000) The Journals of Gerontology Series B:
Psychological Sciences and Social Sciences 55:S308-S318

Objectives.
Studies often fail to adequately test the causal relationship
between volunteering and well-being. Yet the media and empirical
research have focused attention on the impact of volunteering
on the well-being of elderly persons. This study addresses two
questions: First, does volunteering improve the psychological
and physical well-being of elderly persons? Second, do elderly
volunteers experience different benefits than younger adults?
Methods. Using nationally representative panel data, I assessed
the long-term impact of volunteering on the life satisfaction
and perceived health of persons aged 60 and over. I then compared
ordinary least squares regression results for seniors with those
for younger adults. Results. I found that older volunteers experienced
greater increases in life satisfaction over time as a result of
their volunteer hours than did younger adult volunteers, especially
at high rates of volunteering. Older adults experienced greater
positive changes in their perceived health than did younger adult
volunteers. Discussion. The type of volunteer work in which older
and younger adults engage may be part of the reason for these
differential effects. But the context in which older and younger
adults volunteer and the meaning of their voluntarism are more
likely explanations. Researchers should take into account volunteer
commitment when studying volunteering's effect on well-being,
not simply volunteer role.

An Intergenerational
Partnership Between a College and Congregate Housing Facility: How
It Works, What It Means
JA Krout and CH Pogorzala (2002) The Gerontologist 42:853-858

Purpose: We
describe the goals, development, operation, and outcomes of an
intergenerational programmatic relationship between a private
comprehensive college and a congregate facility that houses both
independent-living apartments and assisted living for older adults.
Design and Methods: Activities are based on a communal-developmental
model that promotes "learning with" as opposed to "doing
for." We identify key components involved in implementing
such a model and provide examples of the activities that constitute
the programmatic relationship. We also identify program implementation
challenges and discuss outcomes. Results: Faculty and students
report that partnership activities provide excellent opportunities
for increasing the understanding of aging and older adults. Residents
report programs provide social, recreational, and educational
benefits. Implications: Programmatic partnerships between colleges
and residential facilities for older adults provide many benefits
for students and residents. They require shared responsibility,
deliberate and creative planning, and ongoing coordination.

Purpose: This
article describes the organization, operation, and evaluation
of the Oklahoma Aging Advocacy Leadership Academy (OAALA). Design
and Methods: The Academy was designed to assure the continuation
of future cohorts of advocates and volunteers for aging programs
and services. It is a statewide training program consisting of
10 weekend sessions. The curriculum incorporates age-related content
and advocacy/leadership/voluntary skills training. Evaluation
consisted of: (a) a pre–post assessment of perceived familiarity
with advocacy and volunteer leadership issues; (b) post-Academy
participant assessments of the quality of various aspects of the
Academy; (c) post-Academy written statements about areas that
were valuable and in need of change; and (d) a compilation of
student volunteer and advocacy activities. Results: Evaluation
results indicate that the OAALA led to significant increases in
perceived familiarity with issues and very positive participant
assessments of quality. In addition, many participants spontaneously
initiated advocacy and volunteer activities while enrolled in
the Academy. Implications: Our experience with the Academy suggests
that it is a feasible means of preparing individuals to become
successful old-age advocates and volunteer leaders.

Effects
of Volunteering on the Well-Being of Older Adults
N Morrow-Howell, J Hinterlong, PA Rozario and F Tang (2003)The Journals
of Gerontology Series B: Psychological Sciences and Social Sciences
58:S137-S145

Objectives.
This study tests the effects of volunteering on the well-being
of older adults, including the effect of level of engagement,
the moderating effects of demographic and social factors, and
the effects of the nature of the volunteer experience. Methods.
This is a secondary data analysis of three waves of data from
the Americans' Changing Lives Study. Self-rated health, functional
dependency, and depression are regressed on the well-being measures
from the previous waves, other control variables and volunteer
status, volunteer hours, type and number of volunteer organizations,
and the perceived benefit to others of the volunteer work. Results.
Older adults who volunteer and who engage in more hours of volunteering
report higher levels of well-being. This positive effect was not
moderated by social integration, race, or gender. There was no
effect of the number of organizations for which the older adult
volunteered, the type of organization, or the perceived benefit
of the work to others. Discussion. This work contributes to a
knowledge base that points to the development of social programs
and policies that maximize the engagement of older adults in volunteer
roles. The findings suggest that targeting efforts may not be
warranted, in that there are not differential benefits according
to personal characteristics of the volunteer. Future studies have
to address the nature of the social institutions that will maximize
the number of elders in these roles and the benefits that they
accrue.

Giving
While in Need: Support Provided by Disabled Older Adults
K Boerner and JP Reinhardt (2003) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 58:S297-S304

Objectives.This
paper focuses on predictors and patterns of support provision
over time among disabled older adults. The ability to provide
support to others may become an especially critical issue for
persons who are dealing with a progressive, chronic impairment
that typically results in increased functional disability and
thus places them in greater need for support. Methods.This multilevel
analysis examined change in support provision over time, as well
as the degree to which sociodemographics, health, functional disability,
use of rehabilitation services, and the receipt of support predicted
support provision. Participants, 449 older adults with a progressive,
chronic visual impairment, were interviewed three times over an
18-month period. Results.Affective and instrumental support provided
to family and friends each showed a decrease over time. Age, gender,
and education emerged as predictors of support provided at baseline.
Receipt of support was positively related to support provision
at all three time points, both within and across support types.
Discussion.Findings indicated that there may be feasible ways
of providing support, even by older adults who are in need of
support themselves.

Volunteerism
and Socioemotional Selectivity in Later Life
J Hendricks and SJ Cutler (2004) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 59:S251-S257

Objectives.
The goal of this work was to assess the applicability of socioemotional
selectivity theory to the realm of volunteerism by analyzing data
drawn from the September 2002 Current Population Survey Volunteer
Supplement. Methods. Total number of organizations volunteered
for and total number of hours engaged in volunteer activities
were utilized to obtain measures of volunteer hours per organization
and volunteer hours in the main organization to determine whether
a selective process could be observed. Descriptive statistics
on age patterns were followed by a series of curve estimations
to identify the best-fitting curves. Results. Logistic age patterns
of slowly increasing then relatively stable volunteer activity
suggest that socioemotional selectivity processes are operative
in the realm of voluntary activities. Discussion. Socioemotional
selectivity theory is applicable to voluntary activities.

Formal
Volunteering as a Protective Factor for Older Adults' Psychological
Well-Being
EA Greenfield and NF Marks (2004) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 59:S258-S264

Objectives.
Guided by interactional role theory and employing a resilience
framework, this study aimed to investigate whether formal volunteering
protects older adults with more role-identity absences in major
life domains (partner, employment, and parental) from poorer psychological
well-being. Methods. We used data from 373 participants, aged
65–74, in the 1995 National Survey of Midlife Development
in the U.S. (MIDUS). Multivariate regression models estimated
the effects of major role-identity absences, formal volunteering,
and the interaction between major role-identity absences and volunteering
on respondents' negative affect, positive affect, and purpose
in life. Results. Participants with a greater number of major
role-identity absences reported more negative affect, less positive
affect, and less purpose in life. Being a formal volunteer was
associated with more positive affect and moderated the negative
effect of having more major role-identity absences on respondents'
feelings of purpose in life. Discussion. Consistent with previous
studies, findings indicate that having more role-identity absences
constitutes a risk factor for poorer psychological well-being.
Results further demonstrate that being a formal volunteer can
protect older adults with a greater number of major role-identity
absences from decreased levels of purpose in life. The findings
suggest that associations between volunteering and psychological
well-being might be contingent upon the volunteer's role-identity
status and the dimension of psychological well-being examined.

Altruism
Relates to Health in an Ethnically Diverse Sample of Older Adults
WM Brown, NS Consedine and C Magai (2005) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 60:P143-P152

The existing
literature indicates links between aspects of social network functioning
and health outcomes. It is generally believed that networks that
are larger or provide greater instrumental and emotional support
contribute to improved health and, perhaps, greater longevity.
Recently, it has been suggested that giving as well as receiving
social support may be of benefit. On the basis of evolutionary
theories of emotion and altruism, the current study sought to
test this thesis in a large, ethnically diverse sample of community-dwelling
older adults. As expected, levels of social support given were
associated with lower morbidity, whereas levels of receiving were
not. It is important that these relations held even when (a) socioeconomic
status, education, marital status, age, gender, ethnicity, and
(b) absolute network size and activity limitation were controlled
for. Results are discussed in terms of their implications for
theory regarding the relations among social exchanges, giving,
and later life adaptation among older adults.

OBJECTIVES:
This study's focus on the retiree identity complements research
on institutionalized retirement criteria. We test whether tensions
between individuals' own life circumstances and institutionalized
retirement criteria manifest themselves in the extent to which
individuals assume a retiree identity and in the overlap between
self-definitions and attainment of institutionalized retirement
criteria. METHODS: The analyses rely on logistic regressions and
are based on data from the National Survey of Families and Households
(N = 1,633). RESULTS: Labor force participation serves as the
main basis for the retiree identity, but other life experiences
(work history, disability, spouse's retirement, economic status,
family history) also contribute to individuals' self-identification
as retiree and the "fit" between self-identification
and attainment of institutionalized retirement crieria. Men's
retirement identity seems more closely tied to their attainment
of institutionalized retirement criteria and a continuous and
successful work career, whereas a variety of life circumstances
impinge on women's retiree definitions. Moderately disabled African
Amerians are more likely to self-identify as partly or fully retired.
DISCUSSION: While employment constitutes the main reference for
individuals' self-definition as retiree, other life circumstances
also have some influence. Full understanding of retirement transitions
will require more attention to the meaning context of retirement
among divergent population groups.

The
Impact of Involuntary Job Loss on Subsequent Alcohol Consumption
by Older Workers: Findings From the Health and Retirement Survey
WT Gallo, EH Bradley, M Siegel and SV Kasl (2001) The Journals
of Gerontology Series B: Psychological Sciences and Social Sciences
56:S3-S9

Objective.
To estimate the effect of involuntary job loss on subsequent alcohol
consumption by older workers in the United States. Methods. Using
longitudinal data from the 1992 and 1994 waves of the Health and
Retirement Survey, the authors estimated multivariate models to
assess the impact of involuntary job loss on subsequent alcohol
use. Two outcomes were investigated: reported daily alcohol consumption
and onset of drinking. The analysis sample included 207 workers
who experienced involuntary job loss between survey dates and
a comparison group of 2,866 continuously employed workers. Results.
After baseline alcohol consumption and a variety of socioeconomic
and illness-related covariates were controlled, involuntary job
loss was not associated (p > .05) with number of daily drinks
consumed at follow-up. However, among those who did not consume
alcohol at baseline, individuals who suffered involuntary job
loss were twice as likely as continuously employed individuals
to start drinking by follow-up (OR = 2.01; CI = 1.06–3.80).
The majority of those who began drinking at follow-up reported
drinking less than 1 drink per day. Discussion. The findings provide
evidence of a significant relationship between job loss and subsequent
alcohol use among baseline nondrinkers. However, the magnitude
of the changes in drinking was quite modest.

Who
Expects to Continue Working After Age 62? The Retirement Plans of
Couples
A Mehraban Pienta and MD Hayward (2002) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 57:S199-S208

Objectives.
This study examines the individual, spousal, and household characteristics
associated with the retirement expectations of husbands and wives.
Methods. Using data from the 1992 Health and Retirement Study,
subjective probabilities of working full-time after reaching age
62 and age 65 are used to measure retirement expectations. The
retirement expectations of husbands and wives are modeled simultaneously
using a joint-generalized least-squares approach. Results. Within
a marriage, retirement expectations are shaped by individual,
spousal, and household characteristics. We observe some gender
differences in cross-spousal influence with wives' retirement
expectations being more influenced by husbands' resources and
constraints than vice versa. Nonetheless, individual and household
factors associated with retirement expectations are widely shared
by husbands and wives. Discussion. Husbands and wives both respond
to individual and joint constraints and opportunities when planning
for retirement. Findings support that there is considerable overlap
in retirement planning of husbands and wives during early parts
of the retirement decision-making process. However, inequity in
cross-spousal influences is a defining characteristic of retirement
decision making. Implications for both policy makers and practitioners
are briefly discussed.

Objectives.
This study estimates the consequences of older husbands' involuntary
job loss for their wives' mental health. Methods. Using longitudinal
data from the 1992, 1994, and 1996 waves of the Health and Retirement
Study, multivariate regression models were estimated to measure
the impact of older husbands' involuntary job loss on wives' mental
health. We created two longitudinal data sets of two waves each
to use in our analysis. The first data set, or period, combined
Waves 1 and 2 of the Health and Retirement Study and described
the 1992–1994 experience of spouse pairs in our sample.
It included the wives of 55 husbands who experienced involuntary
job loss between these survey dates and a comparison group of
wives of 730 continuously employed husbands. The second data set
described the 1994–1996 experience of couples. In particular,
it included the wives of an additional 38 husbands who were displaced
from their jobs between Waves 2 and 3, and a comparison group
of wives of 425 husbands who were continuously employed from 1994
to 1996. Results. Husbands' involuntary job loss did not have
a statistically significant effect on wives' mental health. We
found no evidence that changes in husbands' depressive symptoms
modified the effect of his job loss on wives' mental health. In
the first period only, the effect of husbands' job loss on wives'
mental health was more pronounced for wives who were more financially
satisfied at baseline. Discussion. There is limited evidence among
this cohort that husbands' job loss increases wives' subsequent
depressive symptoms. However, the effect of husbands' job loss
on wives' mental health appears to be magnified when wives report
being financially satisfied pre-job loss. This suggests that,
for subgroups of older couples, mental health services specifically
targeted at displaced men should also be made available to wives.

Born
to Retire: The Foreshortened Life Course
DJ Ekerdt (2004) The Gerontologist 44:3-9

Retirement
is no longer a concern solely for the second half of life. Rather,
the idea that we will someday retire is increasingly present to
all adults and it is even urged on adolescents. The earliest reaches
of adulthood are being colonized by frequent reminders that it
takes individual effort to achieve retirement. The changing nature
of pensions, the identification of retirement saving with financial
markets, the politics of Social Security, the aging baby boom
generation, and the interests of a powerful industry and of government
are daily compelling people's attention to retirement as a lifelong
goal. With retirement as adulthood's great project of deferred
gratification, the result could be greater personal readiness
to retire but also some ironic outcomes, such as a stronger retirement
norm, reluctance to spend on children, and outsized expectations
for later life.

Work
at Older Ages in Japan: Variation by Gender and Employment Status
JM Raymo, J Liang, H Sugisawa, E Kobayashi and Y Sugihara (2004)
The Journals of Gerontology Series B: Psychological Sciences
and Social Sciences 59:S154-S163

Objectives.
This study describes the correlates of labor force participation
among Japanese men and women aged 60–85 and examines differences
by gender and employment status. Methods. Using four waves of
data collected from a national sample of older Japanese between
1990 and 1999, we estimate multinomial logistic regression models
for three measures of labor force participation (current labor
force status, labor force exit, and labor force re-entry) as a
function of individual and family characteristics measured 3 years
earlier. Results. Labor force participation is significantly associated
with socioeconomic status, longest occupation, and family structure.
The strength and nature of these relationships differ markedly
for men and women and for wage employment and self-employment.
Discussion. The emphasis on life course experiences and work–family
interdependence characterizing recent research on retirement in
the United States is clearly relevant in Japan as well. To better
understand later-life labor force participation in Japan, subsequent
research should incorporate more direct measures of life course
experiences and family relationships and attempt to make explicit
cross-national comparisons of these relationships.

MULTIPLE
ROLES

Time
use of old and very old Berliners: Productive and consumptive activities
as functions of resources
PL Klumb and MM Baltes (1999) Journals of Gerontology Series
B: Psychological Sciences and Social Sciences, Vol 54, Issue
5 S271-S278

OBJECTIVES:
The aims of this study were to examine time use of elderly women
and men and to explain age- and gender-related variance in activity
levels in terms of differences in available resources. METHODS:
Activities reported in an elderly sample stratified for age and
gender (N = 485, Age: 70-103 years) were aggregated into three
classes: regenerative, productive, and consumptive activities
and regressed on income, presence of a partner in the household,
education, walking mobility, and labor force participation. RESULTS:
Levels in productive and consumptive activities were decreased
in the old-old. Moreover, young-old women spent more time working
in the household than any other group. Most of the age- and gender-related
variance in activity levels could be explained by differences
in available resources. For men, living with a partner was associated
with less time spent for productive activities and enhanced leisure
time, whereas for women, the reverse was observed. The expected
reduction of unpaid work time as a function of income (income
effect) was not observed. DISCUSSION: Elderly individuals do contribute
to societal production. Allocation of time to productive and consumptive
activities is a function of available resources, amounts and effects
of which differ for young-old and old-old as well as for women
and men.

OBJECTIVE:
Research on women's multiple roles frequently adopts one of two
perspectives: role strain, which argues that assuming multiple
roles is detrimental to mental well-being, or role enhancement,
which argues that engaging in multiple roles enhances mental well-being.
We argue that the relationship between role occupancy and well-being
is manifested through multiple dimensions of role experiences.
We investigate the association between depressive symptomatology
and various dimensions of the roles of wife, mother, paid worker,
and informal caregiver to aging parents. METHODS: Data are from
the 1992 wave of the Health and Retirement Study. Depressive symptomatology,
measured by a subset of the CES-D scale, is the dependent variable.
To assess the robustness of findings relative to different functional
forms of the dependent variable, we estimate multiple regression,
log- linear regression, and multinomial logit models. Independent
variables include demographic characteristics, measures of role
occupancy, role demands, and role satisfaction. RESULTS: Although
the number of roles women assume affects their reports of depressive
symptoms, once the demand and satisfaction associated with these
roles is controlled, number has no effect; that is, the effect
of the number of roles is indirect. DISCUSSION: Our results highlight
the importance of women's perceptions of the quality of their
roles in relation to their overall well-being. Future investigations
of women's multiple roles should examine how roles may provide
rewards, impose constraints, or generate conflict, as well as
the extent to which the willingness to assume multiple roles and
the reported levels of role satisfaction and mental well-being
may be jointly endogenous.

Stress
and the devaluation of highly salient roles in late life
N Krause (1999) Journals of Gerontology Series B: Psychological
Sciences and Social Sciences, Vol 54, Issue 2 S99-108

OBJECTIVE:
To see whether older adults cope with stress in highly salient
roles by devaluing the importance of the role in which the event
emerged. METHODS: Interviews were conducted with a nationally
representative sample of elderly people at two points in time:
1992- 1993 and 1996-1997. Complete data are available for 589
older adults. Respondents were asked to identify which of eight
roles they value most highly at both points in time. Information
on the number of stressful events arising in each role was also
obtained. RESULTS: The findings indicate that elderly people are
less likely to devalue highly salient roles when stressful events
are encountered in them. DISCUSSION: The results suggest that
instead of turning away from highly cherished roles when stressful
life events arise, older adult may become more committed to them.

The relationship
between multiple role participation and depressive symptoms experienced
by African American (n = 547) and White (n = 2,152) women aged
55-61 was explored. Data were obtained from the Health and Retirement
Study (HRS). Racial differences in the social roles of marriage,
employment, grandmother, care provider, and volunteer and their
influence on level of depressive symptoms were examined. African
Americans reported higher levels of depressive symptoms than Whites.
Additionally, marriage, employment, and total number of social
roles were the most powerful predictors of depressive symptoms
for both African American and White women. However, employment
was more important in diminishing depressive symptoms among African
American than White women occupying multiple social roles.

Change
in the Centrality of Women's Multiple Roles: Effects of Role Stress
and Rewards
TR Norton, MA Parris Stephens, LM Martire, AL Townsend and A Gupta
(2002) The Journals of Gerontology Series B: Psychological Sciences
and Social Sciences 57:S52-S62

Objectives.
To examine (a) change versus stability over one year in four social
roles occupied by 182 midlife women (parent care provider, mother,
wife and employee), (b) increases in role stress and increases
in role rewards as predictors of change in centrality, and (c)
whether increases in stress or increases in rewards were stronger
predictors when the 2 were considered simultaneously. Method.
Interviews were conducted at 2 time points approximately 1 year
apart. Participants were asked to rate the personal importance
of each role on a scale of 1 to 10. Stress and rewards in each
role were also assessed. Results. Analyses revealed considerable
change in role centrality, especially in the parent-care and employee
roles. Increases in wife and employee stress were associated with
decreases in the centrality of these roles, whereas increases
in rewards in each of the four roles were related to increases
in the centrality of the respective roles. When considered simultaneously,
role rewards were stronger predictors of change in centrality
than role stress. Discussion. These findings suggest that the
centrality of a social role can change over time in response to
stressful and rewarding role experiences.

Purpose: The
goal of this project was to examine the factors related to the
high level of voter turnout among older adults and how these factors
have changed across the past 50 years. The study builds on previous
research efforts by combining individual level analyses from three
nationally representative surveys. Design and Methods: We examined
voter turnout among older citizens using the American National
Election Studies (ANES) 1952–1996, the Current Population
Studies (CPS) 1972–1996, and the General Social Surveys
(GSS) 1972–1996. Logit regression identified significant
factors that contribute to or detract from voting in presidential
elections. Results: Included in the extensive results, we found
that being married, attending church, and contact by political
operatives (since the 1980 election) contributed positively to
older voters' turnout, whereas living in the South was a negative
predictor. Implications: Triangulating data sources, we are able
to utilize the strengths of each study—providing an overview
of the determinants of voter turnout and understanding of the
changes related to older Americans' turnout in presidential elections.

Contemporary
politicians and their advisors focus on older voters as a pivotal
segment of the American electorate. Some analysts predict that
this preoccupation will intensify in the years ahead and the demands
of older persons will dominate American politics. One reason for
this focus on older voters is that they constitute a substantial
proportion of voters today, largely because of age-group differences
in voting turnout rates, and they will be a considerably larger
proportion in the future because of the aging of the baby boom
cohort. This article examines the voting participation of age
groups in past presidential elections and explores what the voting
participation of older persons could be like when the baby boom
cohort reaches old age. The political significance of older persons
being a large percentage of voters is considered with respect
to both the past and the future.

VOLUNTARY
GROUP PARTICIPATION

Age
Differences in Voluntary Association Memberships: Fact or Artifact
SJ Cutler and J Hendricks (2000) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 55:S98-S107

Objectives.
To determine if the curvilinear relationship between age and voluntary
association memberships is due to compositional differences between
age groups. Methods. Data are drawn from 12 nationally representative
surveys covering the period 1974–1994 and including items
on membership in 16 types of associations. Age is categorized
into 14 groups ranging from 18–24 through 85+. Patterns
of age differences in number of association memberships are examined
before and after controlling for several variables related both
to age and to memberships. Results. At the bivariate level, number
of memberships increases through ages 40–44 and then declines
fairly steadily. When controls for compositional differences are
introduced, the curvilinear pattern of age differences is replaced
by one showing an increasing number of memberships through ages
55–59, a slight decrease in the 60–64 age group, and
then generally stable membership levels through the 85+ age group.
Discussion. The lower levels of voluntary association memberships
of older persons consistently identified in bivariate analyses
appear to be largely due to differences in compositional characteristics
between the older and other age groups.

The
Effects of Membership in Church-Related Associations and Labor Unions
on Age Differences in Voluntary Association Affiliations
J Hendricks and SJ Cutler (2001) The Gerontologist 41:250-256

Purpose: When
compositional differences between age groups are controlled, the
bivariate, curvilinear pattern of age differences in voluntary
association memberships is replaced by one in which peak membership
levels occur in late middle age and remain relatively stable thereafter.
We sought to determine if this adjusted pattern persists when
widespread memberships in two types of associations are removed:
(1) church-related organizations, in which membership increases
with age but may be confounded with church membership per se;
and (2) labor unions, in which membership is also widespread but
may not be "voluntary." Design and Methods: Total memberships
in 14 types of associations were examined using aggregated data
from 12 national surveys conducted between 1974 and 1994. Results:
The familiar curvilinear relationship at the bivariate level appears,
but in the multivariate analysis, membership levels rise from
ages 18–24 through 55–59 and persist close to that
level through ages 85 and older. Implications: The results reaffirm
that age differences in voluntary association affiliations are
due to age-based compositional differences; they also show, however,
that the pattern observed with controls is neither driven by membership
in church-related "associations" nor altered when membership
in labor unions is excluded.

Religion
and Cognitive Dysfunction in an Elderly Cohort
PH Van Ness and SV Kasl (2003) The Journals of Gerontology Series
B: Psychological Sciences and Social Sciences 58:S21-S29

Objectives.
This study examines whether attendance at religious services has
an inverse association with cognitive dysfunction in an elderly
cohort in whom it has already been shown that religious attendance
has an inverse association with physical disability and that social
engagement has an inverse association with cognitive decline.
Methods. The study population is a racially and religiously diverse
sample of 2,812 community-dwelling men and women from New Haven,
Connecticut; it was representative of New Haven in 1982, but not
of the United States then or now. The primary study hypothesis
proposes that attendance at religious services as measured in
1982 contributes to the prediction of lower levels of cognitive
dysfunction in 1985 and 1988. A multivariate logistic regression
analysis controlling for seven sociodemographic, four behavioral,
and seven biomedical covariables is conducted. Results. Study
results show an inverse association between religious attendance
in 1982 and cognitive dysfunction in 1985 (odds ratio = 0.64;
95% confidence interval = 0.49, 0.85). Religious attendance as
measured in 1982 no longer contributes to the prediction of cognitive
dysfunction in 1988. Discussion. The short-term nature of the
effect is partially explained by differential mortality. Persons
with infrequent religious service attendance and with high levels
of cognitive dysfunction in 1982 were more likely to die in the
period from 1985 to 1988.

Common
Facets of Religion, Unique Facets of Religion, and Life Satisfaction
Among Older African Americans
N Krause (2004) The Journals of Gerontology Series B: Psychological
Sciences and Social Sciences 59:S109-S117

Objectives.
Common facets of religion are those aspects of religion that can
be shared by people from any racial group. In contrast, unique
facets of religion are available only to people in specific racial
groups. The purpose of this study is to evaluate the interface
among common facets of religion, unique facets of religion, and
life satisfaction in a nationwide sample of older Black people.
Methods. Interviews were conducted with a nationally representative
sample of older African Americans. Survey items were administered
to assess common religious factors (e.g., the frequency of church
attendance) and unique religious factors (i.e., the belief that
religion sustains Black people in the face of racial adversity).
Subjective well-being was measured with a life satisfaction index.
Results. The findings reveal that both the common and the unique
aspects of religion contribute to life satisfaction among older
African Americans. Discussion. Most studies on race differences
in religion focus solely on common religious factors that may
enhance the subjective well-being of older Whites as well as older
Blacks. The findings from this study are important because they
call attention to the insight that can be obtained by also taking
the unique facets of religion for older Black people into consideration.

Objectives.
Studies in the area of religion and mortality are based primarily
on data derived from samples of predominantly non-Hispanic Whites.
Given the importance of religion in the lives of Hispanics living
in the United States, particularly older Hispanics, we examine
the effects of religious attendance on mortality risk among Mexican
Americans aged 65 and older.
Methods. We employ data from the Hispanic Established Populations
for Epidemiologic Studies of the Elderly to predict the risk of
all-cause mortality over an 8-year follow-up period.
Results. Overall, the results show that those who attend church
once per week exhibit a 32% reduction in the risk of mortality
as compared with those who never attend religious services. Moreover,
the benefits of weekly attendance persist with controls for sociodemographic
characteristics, cardiovascular health, activities of daily living,
cognitive functioning, physical mobility and functioning, social
support, health behaviors, mental health, and subjective health.
Discussion. Our findings suggest that weekly church attendance
may reduce the risk of mortality among older Mexican Americans.
Future research should focus on identifying other potential mediators
of the relationship between religious involvement and mortality
risk in the Mexican-origin population.

The literature
on the economic and fiscal impacts of in-migrating retirees on
rural communities tends to concentrate on the younger, more affluent
newly retired. This article addresses an issue not systematically
addressed: the impacts on communities as these retirees age. Households
that vary by age have different income levels and expenditure
patterns. A county-level, conjoined input- output/econometrics
simulation model is used to assess the impacts of an aging rural
population. As hypothesized, the magnitude and nature of impacts
is in direct proportion to relative household size and income
level. The increased local government expenditures are covered
by the increased revenues, even as retirees age.

The Forum
is pleased to publish the following essays on age integration,
which are adapted from a working paper issued in May 1999 by the
National Institute on Aging. The working paper, one component
of NIA's Program on Age and Structural Change (PASC), was edited
by Matilda White Riley and Peter Uhlenberg from contributions
to conferences at the International Sociological Association (in
Montreal) and the American Sociological Association (in San Francisco).
Our purpose is to introduce to a broader readership this important
area of inquiry, as well as to provide specialists with a summary
of the current state of the field.

The
Effect of Widowhood on Older Adults' Social Participation: An Evaluation
of Activity, Disengagement, and Continuity Theories
RL Utz, D Carr, R Nesse, and CB Wortman (2002) The Gerontologist
42:522-533

Purpose: This
study evaluated how levels of social participation change as a
result of late-life widowhood. Social participation is a multidimensional
construct incorporating both formal (e.g., meeting attendance,
religious participation, and volunteer obligations) and informal
(e.g., telephone contact and social interactions with friends)
social roles. Design and Methods: Using data from the Changing
Lives of Older Couples study, analyses compared widowed persons
to continuously married control participants to evaluate whether
widowhood affects older adults' levels of social participation.
Results: Widowed persons had higher levels of informal social
participation than nonwidowed persons, whereas formal social participation
levels were comparable between the two groups. Social participation
levels decrease before the death of a spouse, primarily because
of poor spousal health, and increase following the loss, because
of increased support from friends and relatives. Implications:
Maintaining continuity in the realm of social participation is
a strategy older adults use to cope with spousal loss; however,
not all widowed persons have the same resources to alter their
levels of social participation.

Social
Factors and Mortality in the Old-Old in Israel: The CALAS Study
A. Walter-Ginzburg, T. Blumstein, A. Chetrit and B. Modan (2002)
The Journals of Gerontology Series B: Psychological Sciences
and Social Sciences 57:S308-S318

Objectives.
Using a theoretical framework that divided social factors measures
into structure, function, and social engagement, this study determined
those aspects of social networks most significantly associated
with 8-year, all-cause mortality among the old-old in Israel.
Methods. Jews (n = 1,340) aged 75–94 living in Israel on
January 1, 1989, were randomly selected from the National Population
Register; stratified by age, sex, and place of birth; and interviewed
in person. Mortality was determined according to the National
Death Registry (December 1997). Results. After controlling for
sociodemographics and measures of health, cognitive status, depressive
symptoms, and physical function, the measures of social engagement
that explicitly involved others were associated with a lower risk
of mortality. No measure of the function of the social network
was associated with risk of mortality. Living in the community
without a spouse and with a child and living in an institution
were significantly associated with a higher risk of mortality.
Discussion. The finding that participating in activities with
people outside of the immediate family is associated with a lower
risk of death has practical implications for helping the aging
population and their families in their decision-making process.
Lack of support for the hypothesis that those with more social
support would show reduced risk of mortality may indicate that
the positive effect of perceiving support and the negative effect
of needing support may cancel each other out and result in no
perceived effect. In this population, the association between
socioeconomic status (SES) and the risk of mortality seems to
be expressed through the living arrangements, with the sick and
frail, both in institutions (higher SES) and in the community
with a child or other (lower SES), having a higher risk of mortality.
These findings are consistent with the use of children as a substitute
for institutionalization, and imply that at least some cohabitation
was the caretaking solution for the noninstitutionalized old-old
who were of low SES, frail, and close to death.

Giving
Up and Replacing Activities in Response to Illness
J Duke, H Leventhal, S Brownlee and EA Leventhal (2002) The
Journals of Gerontology Series B: Psychological Sciences and Social
Sciences 57:P367-P376

Data from
a longitudinal study of 250 older adults were used to examine
activity loss and replacement as a consequence of an important
illness episode. Multiple regression analyses revealed that reductions
in activity were predicted by physical factors, specifically illness
chronicity and severity. In contrast, replacing lost activities
was facilitated by social support and optimism and inhibited by
a belief in the need to conserve physical resources. An examination
of the long-term benefits of replacing activities revealed that
older adults who replaced a lost activity had higher positive
affect levels 1 year after illness onset than those who did not
replace activities. Continuing activity during illness episodes
can help maintain positive well-being over time.

Longitudinal
Predictors of Proactive Goals and Activity Participation at Age
80
CK Holahan and JR Chapman (2002) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 57:P418-P425

This study
investigated longitudinal predictors of proactive goals and activity
participation at age 80 among members of the Terman Study of the
Gifted. The participants were 242 individuals between the ages
of 75 and 84 (M = 79.53) who responded to questionnaires in 1992,
1972, and 1950. Proactive goals included goals for involvement
and achievement. Activity participation included intellectual,
cultural, and social service activities. LISREL 8 was used to
test an integrative longitudinal latent variable model of the
associations among the variables. The results showed that purposiveness
at age 40 predicted proactive goals at age 80 indirectly through
satisfaction with cultural life and service to society measured
at age 60. Satisfaction with culture and service at age 60 was
related to activity participation at age 80 through proactive
goals. Women rated proactive goals as more important to them and
indicated greater participation in the activities in this study
than did men, but the structural equation model was invariant
across the two groups. The results are discussed in terms of contemporary
research and theory concerning the self-concept and life span
development.

Social
Participation in Very Old Age: Cross-Sectional and Longitudinal
Findings from BASE
A Bukov, I Maas and T Lampert (2002) The Journals of Gerontology
Series B: Psychological Sciences and Social Sciences 57:P510-P517

Social participation,
defined as socially oriented sharing of individual resources,
is often regarded as an important criterion of quality of life
in old age. We distinguished three types of participation with
respect to content, context, and resources required to participate:
collective, productive, and political participation. Data from
the multidisciplinary Berlin Aging Study were used to describe
social participation of a very old population and to examine individual
differences and changes over time. Analyses showed that social
participation is cumulative. Individuals who engaged in political
activities also took part in the other two types, and those who
engaged in productive activities also participated in collective
activities. Although many persons changed their social participation
over the 4-year period, the cumulative pattern within the population
remained unchanged. Educational and occupational resources were
positively related to the intensity of social participation in
old age, but changes in social participation could be better explained
by age and health.

The
Relation Between Everyday Activities and Successful Aging: A 6-Year
Longitudinal Study
VH Menec (2003) The Journals of Gerontology Series B: Psychological
Sciences and Social Sciences 58:S74-S82

Objectives.
Activity has long been thought to be related to successul aging.
This study was designed to examine longitudinally the relation
between everyday activities and indicators of successful aging,
namely well-being, function, and mortality. Methods. The study
was based on the Aging in Manitoba Study, with activity being
measured in 1990 and function, well-being, and mortality assessed
in 1996. Well-being was measured in terms of life satisfaction
and happiness; function was defined in terms of a composite measure
combining physical and cognitive function. Results. Regression
analyses indicated that greater overall activity level was related
to greater happiness, better function, and reduced mortality.
Different activities were related to different outcome measures;
but generally, social and productive activities were positively
related to happiness, function, and mortality, whereas more solitary
activities (e.g., handwork hobbies) were related only to happiness.
Discussion. These findings highlight the importance of activity
in successful aging. The results also suggest that different types
of activities may have different benefits. Whereas social and
productive activities may afford physical benefits, as reflected
in better function and greater longevity, more solitary activities,
such as reading, may have more psychological benefits by providing
a sense of engagement with life.

Social
Networks, Social Integration, and Social Engagement Determine Cognitive
Decline in Community-Dwelling Spanish Older Adults
MV Zunzunegui, BE Alvarado, T Del Ser and A Otero (2003) The
Journals of Gerontology Series B: Psychological Sciences and Social
Sciences 58:S93-S100

Objectives.
To examine the influence of social networks and social engagement
on cognitive decline in a population-based cohort of elderly people,
and to assess gender differences in the effect of social relations
on cognition. Methods. A longitudinal study of community-dwelling
people over 65 was carried out. Cognitive function (orientation
and memory) in 1997 and cognitive decline (absent, mild, and severe)
over 4 years (1993–1997) were assessed using an instrument
previously validated for populations with a low level of education.
The effect of social networks, social integration, and social
engagement with friends, children, and relatives on cognitive
function and cognitive decline was estimated by multiple linear
and logistic regressions after adjusting for age, sex, education,
depressive symptoms, systolic and diastolic blood pressure, and
functional status. Results. Poor social connections, infrequent
participation in social activities, and social disengagement predict
the risk of cognitive decline in elderly individuals. The probability
of cognitive decline was lower for both men and women with a high
frequency of visual contact with relatives and community social
integration. Engagement with friends seemed to be protective for
cognitive decline in women but not in men. Discussion. This longitudinal
study indicates that few social ties, poor integration, and social
disengagement are risk factors for cognitive decline among community-dwelling
elderly persons. The nature of the ties that influence cognition
may vary in men and women.

Age-Related
Declines in Activity Level: The Relationship Between Chronic Illness
and Religious Activities
M Reindl Benjamins, MA Musick, DT Gold and LK George (2003) The
Journals of Gerontology Series B: Psychological Sciences and Social
Sciences 58:S377-S385

Objectives.
When they are faced with major life transitions such as worsening
health, older adults may selectively withdraw from activities.
Because of the importance of religion to a large proportion of
the elderly population, research is needed to determine whether
levels of religious involvement are affected by serious health
problems such as the onset of a chronic disease. Methods. Multiple
waves of data from the Duke Established Populations for Epidemiologic
Studies of the Elderly were used to analyze the effects of five
different chronic conditions on two religious activities: service
attendance and religious media use. Results. Findings show that
broken hip, cancer, and stroke were significantly related to levels
of religious attendance. Furthermore, the combined conditions
also significantly predicted religious attendance, with more conditions
being associated with lower attendance. Neither the individual
or summed conditions were significantly related to religious media
use. Discussion. The study finds some evidence to support the
idea that older adults withdraw from social activities such as
religious involvement when faced with declining health. In contrast,
levels of religious media use remain stable following the onset
of one or more new chronic conditions.

Subjective
Usefulness and 6-Year Mortality Risks Among Elderly Persons in Japan
K Okamoto and Y Tanaka (2004) The Journals of Gerontology Series
B: Psychological Sciences and Social Sciences 59:P246-P249

Several studies
have demonstrated that the loss of a sense of one's own self-worth
has an influence on the health status, psychological functioning,
and quality of life in the aged. We used longitudinal data from
784 elderly residents (mean age = 73 years) to examine the relationship
between subjective usefulness and 6-year mortality. We hypothesized
that subjective usefulness is an important indicator of quality
of life among the elderly population, and subsequently of mortality.
We elicited information on subjective usefulness at baseline by
using a self-administered questionnaire. Results of longitudinal
analyses showed that subjective usefulness may be significantly
associated with self-rated health and subsequent mortality. This
indicates that subjective usefulness plays an important role in
enhancing survival in the elderly population.

A Longitudinal
Study of Black–White Differences in Social Resources
LL Barnes, CF Mendes de Leon, JL Bienias and DA Evans (2004) The
Journals of Gerontology Series B: Psychological Sciences and Social
Sciences 59:S146-S153

Objectives.
This study examined the differences in levels of social networks
and social engagement between older Blacks and Whites and racial
differences in rates of change in social resources over time.
Methods. The sample consisted of 5,102 Blacks and Whites, aged
65 and older, from the Chicago Health and Aging Project, who underwent
up to three interviews during an average of 5.3 years of follow-up.
Repeated measures of social networks were based on the number
of children, relatives, and friends seen at least once a month.
Social engagement was measured at each interview with four items
related to social and productive activity. Random effects models
were fitted to test the effect of race on social resources and
change in resources over time. Results. Blacks had smaller social
networks and lower levels of social engagement than Whites. Racial
differences in these resources were stable during follow-up. Socioeconomic
status reduced racial differences in social engagement but not
social networks. Discussion. The findings provide evidence for
lower levels of social resources among older Blacks. There was
little evidence that racial differences were the result of greater
decline during old age itself.

Linking
the Two Ends of Life: What Gerontology Can Learn From Childhood
Studies
RA Settersten, Jr., (2005) The Journals of Gerontology Series
B: Psychological Sciences and Social Sciences 60:S173-S180

This paper
extends provocative ideas from the emerging interdisciplinary
field of childhood studies to the field of gerontology. These
ideas constitute a framework for building new kinds of theories
and research on old people and old age—gathered around rights
and responsibilities of and for old people; focused on their agency
and social participation; concerned with the social problems of
old people, as well as how old people are constructed to be social
problems; anchored in their perspectives and voices; dedicated
to describing and explaining both commonness and difference in
their experiences and statuses; devoted to understanding old people
as beings and becomings; and attentive to the interdependence
of generations within families and societies. These commitments
will require gerontology to strengthen its treatment of sociocultural
phenomena, prompt more genuinely interdisciplinary scholarship,
and advocate a wider range of research methods and data. A "new
social studies of old people and old age," nurtured around
these ideas, will also raise the visibility of old people and
old age in science, public policy, and social life.